BREONNA SHANICE WILLIS NPI 1871198994

NPI Information

NPI: 1871198994
Provider Name: BREONNA SHANICE WILLIS
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
482 S KELLER RD
ORLANDO, FL
ZIP 32810
Phone: (689) 204-3341
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Breonna Shanice Willis is a counselor in Orlando, FL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Breonna Shanice Willis NPI is 1871198994. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

482 S KELLER RD
ORLANDO, FL
ZIP 32810-130
Phone: (689) 204-3341

The enumeration date for this NPI number is 12/4/2020 and was last updated on 12/4/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	62395	OTHER	FLORIDA	CHILDREN'S HOME SOCIETY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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